Risk Factors for the Development of Delayed Graft Function in Deceased Donor Renal Transplants

Introduction: Delayed renal graft function (DGF) is associated with various factors and with a higher complication rate in the posttransplant period. Determination of center-specific risk factors may help to reduce the incidence of DGF and improve transplantation results. The aim of this study was to define risk factors for the development of DGF after renal transplantation. Patients and Methods: This study included 290 consecutive deceased donor renal transplantations performed in a single center between January 1, 2004, and November 30, 2007. All cases were examined for the presence of DGF, defined as the need for at least 1 dialysis during the first posttransplant week. The subjects were divided into 2 groups: immediate graft function and DGF. Both groups were compared for donor and recipient transplantation factors as well as early posttransplant results. Results: DGF was observed in 61 cases (21%). Our analysis revealed associations of DGF with recipient age (P = .011), female gender (P = .028), donor age (P = .033), body mass index (P = .007), severe hemodynamic disturbances (P = .005) preexistent glomerular or interstitial sclerosis (P = .002 or P = .028, respectively); and cold ischemia time (CIT; P = .019). Trends toward significance were observed with recipient weight > 100 kg (P = .078), and diabetes mellitus (P = .109). Recipients who experienced DGF showed on higher rate of acute rejection, a longer hospital stay, and an higher level serum creatinine at discharge (P < .001 for all). Conclusion: DGF had deleterious effects in the early posttransplant period. Careful allocation and reduction of CIT may improve transplantation results.